Device, system, and method for determining a reading environment by synthesizing downstream needs

ABSTRACT

A device, system, and method determines a reading environment by synthesizing downstream needs. The method at a workflow server includes receiving a request from a physician device utilized by a referring physician, the request directed to performing an imaging procedure. The method includes determining at least one normalized need from the request, the normalized need corresponding to the referring physician. The method includes generating information to be included in a reading environment based on the at least one normalized need, the information assisting an image interpreter in interpreting the imaging procedure.

BACKGROUND INFORMATION

A physician may provide healthcare services to patients using a varietyof different procedures and recommending a variety of differenttreatments. The physician may tailor the healthcare services for thepatient based on a diagnosis determined by the physician using anyavailable information of the patient. For example, the physician mayreceive answers to medically related questions, personally examineparticular body areas, refer to other test results of the patient, etc.When using a test result from a procedure performed on the patient suchas by an image interpreter, the physician may first recommend that theprocedure be performed. Thus, the physician may refer the patient to theimage interpreter such that the test result may be obtained and providedto the physician.

The image interpreter may capture images of a desired area of thepatient using a variety of different procedures and a variety ofdifferent approaches. However, the referring physician may requireimages using a specific procedure and a specific approach. For example,a referring physician relies on quantitative data points extracted fromimaging studies (e.g., an oncologist generally expects two-dimensionalmeasurements of representative tumors). Unless this information isprovided to the image interpreter and the image interpreter acknowledgesthis information, an image reading environment used by the imageinterpreter is likely to not be responsive to the needs and expectationsof the referring physician. Accordingly, the burden of configuring thereading environment is placed on the image interpreter to synthesize thedownstream needs and expectations (of the referring physician) as wellas to manually configure supportive technology to address these needsand expectations. This process is often laborious and time consuming forthe image interpreter which increases the time required for results tobe relayed back to the referring physician. In addition, as the numberof available workflow solutions grows, the selection of the workflow andthe manner to utilize the selected workflow for the reading environmentbecomes more challenging for the image interpreter.

An approach used to alleviate the efforts of the image interpreter insynthesizing the downstream needs and expectations of the referringphysician is to enable the image interpreter to create and documentquantitative data points more accurately and more efficiently. Aconventional manner is a Measurement Assistant (MA) which is a picturearchiving and communication system (PACS) workflow solution that allowsan image interpreter to manage tumor measurements longitudinally. The MApersists the measurements electronically so that the measurements may bere-used in a format that is appropriate for the referring physician andallows generation of a free-text measurements section for inclusion inthe narrative report.

Although the MA appears to provide a solution to the above describedproblem, the MA itself also has drawbacks that do not fully address therequirement of determining the downstream needs and expectations of thereferring physician. For example, there must be an underlying assumptionthat the MA is universally adopted and used after installation, which isnot guaranteed. In fact, studies have indicated that a conservativeestimate for adoption of MA by radiologists reaches around 80% for tumormeasurements read with MA. Even with encouragement features to utilizeMA (e.g., educational sessions, gentle reminders, user-specificscorecards, etc.) and an auto-launch capability of MA, the use of MAdoes not reach universal adoption, particularly in view of the manualcontribution needed for using MA. That is, there are still instanceswhere the image interpreter is required to determine the downstreamneeds and expectations of the referring physician.

In a particular example, if a patient having an imaging procedureperformed has no prior image examinations that were read with MA, the MAapplication does not auto-launch, even with such a capability enabled.The patient may not have prior image examinations for many reasonsincluding being a new patient, a previous patient having new tumors,etc. Therefore, there is a problem with identifying the needs of thereferring physician to the image interpreter. When the imaging procedureis eventually scheduled, there may be a lack of communication regardingthe specifics of the imaging procedure that correlate to the needs ofthe referring physician.

SUMMARY

The present application is directed to a method, comprising: at aworkflow server: receiving a request from a physician device utilized bya referring physician, the request directed to performing an imagingprocedure; determining at least one normalized need from the request,the normalized need corresponding to the referring physician; andgenerating information to be included in a reading environment based onthe at least one normalized need, the information assisting an imageinterpreter in interpreting the imaging procedure.

The present application is directed to a workflow server, comprising: atransceiver communicating via a communications network, the transceiverconfigured to exchange data with a physician device utilized by areferring physician and an image interpreter device utilized by an imageinterpreter; a memory storing an executable program; and a processorthat executes the executable program that causes the processor toperform operations, comprising, receiving a request from a physiciandevice utilized by a referring physician, the request directed toperforming an imaging procedure; determining at least one normalizedneed from the request, the normalized need corresponding to thereferring physician; and generating information to be included in areading environment based on the at least one normalized need, theinformation assisting an image interpreter in interpreting the imagingprocedure.

The present application is directed to a method, comprising: at aworkflow server: receiving a request from a physician device utilized bya referring physician, the request directed to performing an imagingprocedure; determining at least one normalized need from the request,the normalized need corresponding to the referring physician;determining at least one workflow solution based on the at least onenormalized need, the at least one workflow solution respectivelyassociated with defining a manner that the imaging procedure is to beperformed; and generating a reading environment based on the at leastone normalized need, the reading environment providing the at least oneworkflow solution.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 shows a system according to the exemplary embodiments.

FIG. 2 shows a workflow server of FIG. 1 according to the exemplaryembodiments.

FIG. 3 shows a method for determining a reading environment according tothe exemplary embodiments.

DETAILED DESCRIPTION

The exemplary embodiments may be further understood with reference tothe following description and the related appended drawings, whereinlike elements are provided with the same reference numerals. Theexemplary embodiments are related to a device, a system, and a methodfor imaging procedures to be more efficiently performed on a patient byan image interpreter based on needs and/or expectations of a referringphysician. Specifically, the exemplary embodiments are configured toautomatically detect the needs/expectations of a referring physician andautomatically configure or modify a reading environment based on theseneeds/expectations for the image interpreter. Accordingly, the imageinterpreter is not required to determine any downstream needs of thereferring physician. In this manner, the image interpreter may performthe imaging procedure with the provided reading environment and returnthe test results to the referring physician which satisfy thephysician's requirements.

It is noted that the exemplary embodiments are described with regard toa reading environment for an image interpreter with downstream needsrelating to a referring physician. However, the image interpreter, theimaging procedure, and the reading environment are only exemplary. Theexemplary embodiments may be modified to be used with any process flowin which a referring physician has a set of needs/expectations and thisinformation is used as a basis for a further clinician to perform aprocedure and generate results. It is also noted that the connection tothe medical field is only exemplary. The exemplary embodiments may alsobe modified to be used with any process flow in which a first user has aset of needs/expectations and a second user performs an operation andgenerates results based on this information.

As used herein, the referring physician has needs and/or expectationswith regard to results provided by the image interpreter. These needsand expectations may represent or cover any need, expectation or othervalue extracted from an imaging interpretation, created by imageinterpreter interaction with the image examination, and documented inthe imaging report and/or any workflow solution. Theseneeds/expectations are hereinafter collectively referred to as “needs.”

For illustrative purposes, the exemplary embodiments may assume apresence of and access to one or more workflow solutions. For example,the workflow solutions may include longitudinal quantificationtechnology, image segmentation technology, computer-aided detectiontechnology, computer-aided diagnosis technology, guideline-basedrecommendation technology, search technology, etc. Accordingly, theworkflow solution may be any automated application that assists an imageinterpreter in interpreting images captured using an imaging procedure.However, the selection and use of existing workflow solutions is onlyexemplary and the exemplary embodiments may be modified to determineand/or create a workflow solution to be used in the reading environment.The exemplary embodiments also utilize reading environments that areused with various imaging procedures. However, the exemplary embodimentsmay be modified to determine and create the reading environment as well.

FIG. 1 shows a system 100 according to the exemplary embodiments. Thesystem 100 relates to a communication between various componentsinvolved in providing healthcare to a patient. Specifically, the system100 may relate to a scenario when a physician refers the patient to animage interpreter for an imaging procedure to be performed to generatetest results that are returned to the referring physician. The system100 may include a physician device 105, a communications network 110,and an image interpreter device 115. As will be described in furtherdetail below, the system 100 is configured to modify a readingenvironment to include information that assists the image interpreter ininterpreting an imaging procedure where the information may includeworkflow solutions that correspond to the needs of the referringphysician. Accordingly, the system 100 may also include a workflowserver 120 and a solution repository 125.

The physician device 105 may represent any electronic device that isconfigured to perform the functionalities associated with a physician.For example, the physician device 105 may be a portable device such as atablet, a laptop, etc. or a stationary device such as a desktopterminal. The physician device 105 may include the necessary hardware,software, and/or firmware to perform the various operations associatedwith medical treatment. The physician device 105 may also include therequired connectivity hardware, software, and firmware (e.g.,transceiver) to establish a connection with the communications network110 to further establish a connection with the other components of thesystem 100.

The physician device 105 may be configured to enable the physician toperform the various operations associated with medical treatment. Forexample, the physician device 105 may schedule appointments for patientsusing a calendar application, may track treatments or procedures of apatient, etc. In another example, the physician device 105 may scheduleor request an imaging procedure to be performed on the patient. That is,the physician device 105 may recommend the imaging procedure to thepatient and, when the patient agrees, it may refer the patient to animage interpreter to perform the imaging procedure. Thus, the physicianmay utilize the physician device 105 to enter the request along with anyother information. In a further example and as will become apparentbelow, the physician device 105 may receive test results associated withan imaging procedure and display the results to the physician.

The communications network 110 may be configured to communicativelyconnect the various components of the system 100 to exchange data. Thecommunications network 110 may represent any single or plurality ofnetworks used by the components of the system 100 to communicate withone another. For example, if the physician device 105 is used at ahospital, the communications network 110 may include a private networkwith which the physician device 105 may initially connect (e.g. ahospital network). The private network may connect to a network of anInternet Service Provider to connect to the Internet. Subsequently,through the Internet, a connection may be established to otherelectronic devices. For example, the workflow server 120 may be remoterelative to the hospital but may be connected to the Internet. Thus, thephysician device 105 may be communicatively connected to the workflowserver 120. It should be noted that the communications network 110 andall networks that may be included therein may be any type of network.For example, the communications network 110 may be a local area network(LAN), a wide area network (WAN), a virtual LAN (VLAN), a WiFi network,a HotSpot, a cellular network (e.g., 3G, 4G, Long Term Evolution (LTE),etc.), a cloud network, a wired form of these networks, a wireless formof these networks, a combined wired/wireless form of these networks,etc.

The image interpreter device 115 may represent any electronic devicethat is configured to perform the functionalities associated with animage interpreter. For example, like the physician device 105, the imageinterpreter device 115 may be a portable device such as a tablet, alaptop, etc., or a stationary device such as a desktop terminal. Theimage interpreter device 115 may also include the necessary hardware,software, and/or firmware to perform the various operations associatedwith imaging procedures. The image interpreter device 115 may alsoinclude the required connectivity hardware, software, and firmware(e.g., transceiver) to establish a connection with the communicationsnetwork 110 to further establish a connection with the other componentsof the system 100.

The image interpreter device 115 may be configured to enable the imageinterpreter to perform the various operations associated with imagingprocedures. As those skilled in the art will understand, there are aplurality of different imaging procedures that may be performed usingdifferent imaging modalities. For example, the imaging procedures may bean X-ray procedure, a computed tomography (CT) procedure, a magneticresonance imaging (MRI) procedure, an ultrasound procedure, a positronemission tomography (PET) scan procedure, a single-photon emissioncomputed tomography (SPECT) scan procedure, or hybrids thereof, and etc.Each imaging procedure may utilize a reading environment upon which theimage interpreter may capture and interpret images. As will be describedin further detail below, the image interpreter device 115 may receiveinformation that is included in the reading environment from theworkflow server 120 that assists the image interpreter in interpretingthe imaging procedure (e.g., the manner in which the imaging procedureis to be performed for the patient). The image interpreter device 115may continuously exchange data with the workflow server 120 during thetime the imaging procedure is being performed such as inputs provided bythe image interpreter. Once the imaging procedure is completed, theimage interpreter device 115 may transmit the test results of theimaging procedure to the physician device 105.

The workflow server 120 may be a component of the system 100 thatperforms functionalities associated with determining the informationthat is to be included in the reading environment according to theexemplary embodiments. As will be described in further detail below, theworkflow server 120 may receive a request or information from areferring physician utilizing the physician device 105, determineinformation (e.g., workflow solutions) to be included in the readingenvironment based on the needs of the referring physician, and providethe modified reading environment to the image interpreter device 115 foran imaging procedure to be performed. The workflow server 120 mayutilize various functionalities and operations as well as workflowsolutions to determine the reading environment. The functionalities andoperations of the workflow server 120 in determining information that isincluded in the reading environment may be performed as a preliminarystep and/or during a time the image interpreter is performing theimaging procedure.

The solution repository 125 may represent any source from which workflowsolutions are stored and retrieved by the workflow server 120. Asdescribed above, the workflow solutions may be based on longitudinalquantification technology, image segmentation technology, computer-aideddetection technology, computer-aided diagnosis technology,guideline-based recommendation technology, search technology, etc.Accordingly, the solution repository 125 may be sources upon which thesevarious technologies perform their respective functionalities to providea corresponding output of a workflow solution. In another exemplaryembodiment, the solution repository may be a data storage component thatstores the workflow solutions from further electronic components thatutilize these various technologies. The solution repository 125 maystore existing workflow solutions that may be selected for use with theinformation included in the reading environment according to theexemplary embodiments. However, it is again noted that the workflowserver 120 may be modified to determine and create a workflow solutionthat is to be used in the reading environment.

It should be noted that the system 100 illustrating a single solutionrepository 125 is only exemplary. The solution repository 125 mayrepresent one or more sources of workflow solutions that may be accessedby the workflow server 120. For example, the technologies upon which theworkflow solutions are generated may each have a respective solutionrepository 125. In another example, a plurality of technologies may beprovided by a single source such that a single solution repository 125may be used for these plurality of technologies.

It is also noted that the system 100 may also include a plurality ofphysician devices 105, a plurality of image interpreter devices 115, anda plurality of workflow servers 120. That is, many different physiciansand image interpreters may utilize the system 100. There may also bemany different workflow servers 120 that service different physiciandevices 105 and image interpreter devices 115.

As described above, the workflow server 120 may determine the readingenvironment based on the needs of the referring physician. FIG. 2 showsthe workflow server 120 of FIG. 1 according to the exemplaryembodiments. The workflow server 120 may provide various functionalitiesin determining the information to be included in the readingenvironment. Although the workflow server 120 is described as a networkcomponent (specifically a server), the workflow server 120 may beembodied in a variety of hardware components such as a portable device(e.g., a tablet, a smartphone, a laptop, etc.) or a stationary device(e.g., a desktop terminal). The workflow server 120 may be incorporatedinto the physician device 105 and/or the image interpreter device 115,or incorporated into a website service, etc. The workflow server 120 mayinclude a processor 205, a memory arrangement 210, a display device 215,an input and output (I/O) device 220, a transceiver 225, and othercomponents 230 (e.g., an imager, an audio I/O device, a battery, a dataacquisition device, ports to electrically connect the workflow server120 to other electronic devices, etc.).

The processor 205 may be configured to execute a plurality ofapplications of the workflow server 120. As will be described in furtherdetail below, the processor 205 may utilize a plurality of enginesincluding a need detection engine 235, a configuration engine 240, aserialization engine 245, a contextual engine 250, and an output engine255. The need detection engine 235 may be configured to capture andnormalize the needs of the referring physician. The configuration engine240 may be configured to map the normalized needs of the referringphysician onto an array of workflow solutions. The serialization engine245 may be configured to serialize workflow solutions to ensurepresentation of the workflow solutions in an appropriate order. Thecontextual engine 250 may be configured to prioritize the use ofworkflow technology based on contextual cues. The output engine 255 maybe configured to generate the information to be included in a readingenvironment based on information from the other engines 235-250.

It should be noted that the above noted applications and engines eachbeing an application (e.g., a program) executed by the processor 205 isonly exemplary. The functionality associated with the applications mayalso be represented as components of one or more multifunctionalprograms, a separate incorporated component of the workflow server 120or may be a modular component coupled to the workflow server 120, e.g.,an integrated circuit with or without firmware.

The memory 210 may be a hardware component configured to store datarelated to operations performed by the workflow server 120.Specifically, the memory 210 may store data related to the variousengines 235-255 such as the request and the needs of the referringphysician. The display device 215 may be a hardware component configuredto show data to a user while the I/O device 220 may be a hardwarecomponent that enables the user to enter inputs. For example, anadministrator of the workflow server 120 may maintain and update thefunctionalities of the workflow server 120 through user interfaces shownon the display device 215 with inputs entered with the I/O device 220.It should be noted that the display device 215 and the I/O device 220may be separate components or integrated together such as a touchscreen.The transceiver 225 may be a hardware component configured to transmitand/or receive data via the communications network 110.

According to the exemplary embodiments, the workflow server 120 mayperform various different operations to determine the information to beincluded in the reading environment that is used by the imageinterpreter to generate test results for the referring physician.Initially, as described above, the need detection engine 235 may beconfigured to capture and normalize the needs of the referringphysician. Accordingly, the referring physician may utilize thephysician device 105 to enter a request for an imaging procedure. Therequest may be transmitted to the workflow server 120. Specifically, theneed detection engine 235 may receive the request that is provided inthe context of ordering the imaging procedure. The need detection engine235 may subsequently convert the request into a series of normalizedneeds corresponding to the referring physician. For example, a firstphysician may have a first set of needs to view an area of the patientwhereas a second physician may have a second set of needs to view thesame area of the patient. If the first physician were to enter therequest, the first set of needs would be used as the basis ofdetermining the reading environment.

In a specific implementation of the need detection engine 235 accordingto the exemplary embodiments, a predetermined data scheme may be used.The predetermined data scheme may list all potential needs of referringphysicians. More particularly, the needs of the predetermined datascheme may be hierarchically structured. For example, the needs of thepredetermined data scheme may include a tree structure in which thereferring physician requires an image quantification from an imagingprocedure. Accordingly, a first level of needs may be labeled as “imagequantification.” The image quantification may include sub-requirementssuch as oncological and vascular. Accordingly, a second level of needsunder “image quantification” may be “oncological” and “vascular.” Theoncological sub-requirement may also include sub-requirements such asstandards set forth by the World Health Organization (WHO), the ResponseEvaluation Criteria in Solid Tumors (RECIST) 1.0, and RECIST 1.1.Accordingly, a third level of needs under “oncological” may be “WHO,”“RECIST 1.0,” and “RECIST 1.1.”

The need detection engine 235 may receive the request from the physiciandevice 105 in a variety of manners. In a first example, the referringphysician may enter text that provides information relating to theimaging procedure being requested. For example, the referring physicianmay enter text on the physician device 105 to describe a patienthistory, current symptoms, the reason for the imaging procedure,clinical questions, etc. The referring physician may also elaborate onthe reason for the imaging procedure to capture downstream needs (e.g.,“Please make RECIST measurements.”). When this text is entered by thereferring physician on the physician device 105, the physician device105 may subsequently transmit this data to the workflow server 120.

When the workflow server 120 receives the request from the physiciandevice in this format, the need detection engine 235 may filter the datausing natural language processing operations that normalize the termsfor mapping onto the needs of the predetermined data scheme. The needsof the predetermined data scheme may be organized as a list of keywordsand/or key phrases. Accordingly, the lexical elements of the terms fromthe request may be used to perform a search on the normalized needs ofthe predetermined data scheme such as with pre-processing techniques(e.g., stemming). In a particular example, if the reason for the imagingprocedure contains the term “RECIST” which has been identified by theneed detection engine 235, the need detection engine 235 may map thisterm to a normalized need corresponding to “Response Evaluation Criteriain Solid Tumors 1.1.” The need detection engine 235 may support furtheroperation in filtering the data of the request and mapping to thenormalized needs. For example, the need detection engine 235 may utilizea negation detection operation, a concept extraction operation, etc.

In a second example of receiving the request, the workflow server 120may provide a dedicated user interface environment to the physiciandevice 105. The dedicated user interface environment may enable thereferring physician to mark any needs in an electronic and structuredmanner. For example, the needs of the predetermined data scheme may bepresented on the physician device 105 to the referring physician as atree structure wherein items are selectable. The dedicated userinterface environment may integrate dynamic and predetermined operationsin receiving inputs from the referring physician. In an exemplaryoperation, the need detection engine 235 may take into account aspecialty of the referring physician and filtering the normalized needsof the predetermined data scheme using a mapping for this specialty. Forexample, if the referring physician is an oncologist, the referringphysician may select a first need as “Quantification” which may lead toa following need of “Oncological” whereas another referring physicianwhose specialty is cardiology will not be presented “Oncological” (butmay instead be presented with “Cardiological”).

In a third example, the need detection engine 235 may utilize profiles.In a first example of using profiles, the need detection engine 235 maystore a plurality of dedicated profiles where each dedicated profileincludes a combination of normalized needs of the predetermined datascheme. Each dedicated profile may be assigned a header that may beretrieved by selecting the profile specifically from a dedicated userinterface. For example, the header may state “Research protocol XYZ,”“Standard Oncological Quantification,” etc. In a second example of usingprofiles, the need detection engine 235 may store a user profile for thereferring physician that includes a combination of normalized needs ofthe predetermined data scheme. Thus, if a referring physician has arequest for an imaging procedure and a common set of needs are used bythe referring physician, the referring physician may select the userprofile (which may include or exclude normalized needs that are part ofdedicated profiles). However, if the referring physician should requirea different set of needs, the referring physician may override aselection of the user profile. The user profile may be created manuallyor automatically. For example, the referring physician may manuallyselect the normalized needs to be included in the user profile. Inanother example, based on previously selected normalized needs ordedicated profiles, the need detection engine 235 may create the userprofile to include a personalized set of normalized needs.

The configuration engine 240 maps the normalized needs of the referringphysician onto an array of workflow solutions. As described above, theworkflow server 120 may have access to the solution repository 125 whichstores a plurality of workflow solutions that are based on a variety ofdifferent technologies. Again, the workflow solutions may be anyautomated application that assists the image interpreter in interpretingcaptured images from the imaging procedure. For example, the workflowsolution may define settings in which the images are to be captured, aposition/angle in which the images are to be captured, etc. Theconfiguration engine 240 may be configured to receive the normalizedneeds from the need detection engine 235 and determine whether thenormalized needs may be mapped onto one or more workflow solutions.Accordingly, depending on the normalized needs, the configuration engine240 may map to zero workflow solutions, one workflow solution, or morethan one workflow solutions.

According to an exemplary embodiment, the configuration engine 240 mayleverage a mapping table that associates the normalized needs receivedfrom the need detection engine 240 with workflow solutions addressingthe needs. For example, the configuration engine 240 may map the needfor RECIST 1.1 measurements onto a picture archiving and communicationsystem (PACS) workflow solution. Once mapped, the output of theconfiguration engine 240 may be an array of Booleans that indicatewhether the workflow solution associated with a particular cell in thearray is to be activated. In this manner, each workflow solution that isincluded for consideration may be activated or remain deactivatedthrough the mapping performed by the configuration engine 240.

In a further feature, the configuration engine 240 may utilize morespecific information that is stored to configure the reading environmentof the image interpreter as well as the individual workflow solutions.For example, the PACS workflow solution may be configured differentlydepending on whether the normalized need is WHO, RECIST 1.0, or RECIST1.1. Specifically, the WHO guideline utilizes uni-dimensionalmeasurements whereas the RECIST 1.1 utilizes bi-dimensionalmeasurements. Thus, if the need is identified and normalized tocorrespond to RECIST 1.1, the configuration engine 240 may provide asignal to a subsequent component (e.g., the output engine 255) toindicate that the image interpreter may be alerted that a finding whichwas measured in only one dimension requires that another measurement bemade.

The serialization engine 245 serializes workflow solutions to ensurepresentation of the workflow solutions in an appropriate order.Initially, the serialization engine 245 may provide an enhanced featurethat is utilized for the information that is included in the readingenvironment according to the exemplary embodiments. That is, theworkflow server 120 may be configured to omit the use of theserialization engine 245 such as when zero or only one workflow solutionhas been mapped to the normalized needs. In another example, theworkflow server 120 may be configured to omit the use of theserialization engine 245 when a serial dependency (as described below)does not exist.

The workflow solutions that may be utilized by the workflow server 120may have a serial dependency. That is, a first workflow solution may berequired prior to a second workflow solution being available for use.For example, the first workflow solution may be associated with imaginga general area and the second workflow solution may be associated with amore specific imaging within the general area. Thus, without firstimaging the general area, the second workflow solution cannot belogically used. In this manner, the output of the first workflowsolution may be required as an input for the second workflow solution.It is noted that this serial dependency may only apply to certainworkflow solutions since one or more workflow solutions may standindependently with no relationship to other workflow solutions.

When a serial dependency does exist between the workflow solutionsmapped by the configuration engine 240, the serialization engine 245 maygenerate a signal for a subsequent component (e.g., the output engine255) to present the first workflow solution prior to the second workflowsolution. That is, the second workflow solution should not be launchedprior to the first workflow solution. The serialization engine 245 mayutilize a table of all relationships between the available workflowsolutions such that identification of any workflow solution having aserial dependency may result in an ordering to be identified or whetheranother workflow solution may be required to be added (e.g., when theoutput of the first workflow solution is required for the secondworkflow solution but only the second workflow solution was mapped). Theserialization engine 245 may then structure the workflow solutions foundby the configuration engine 240 by retrieving their pairwisedependencies. The result may be represented as a non-cyclic graph.

The contextual engine 250 prioritizes the use of workflow technologybased on contextual cues. Initially, substantially similar to theserialization engine 245, the contextual engine 250 may provide anenhanced feature that is utilized in further developing the readingenvironment according to the exemplary embodiments. That is, theworkflow server 120 may be configured to omit the use of thefunctionalities of the contextual engine 250. For example, as will bedescribed in detail below, the contextual engine 250 operates with theoutput engine 255 since inputs received from the image interpreter areutilized by the contextual engine 250. Thus, if the image interpreterdevice 115 utilizes a reading environment provided by the output engine255 without exchanging data with the workflow server 120 and onlyprovides the test results after the imaging procedure is completed, thefeatures of the contextual engine 250 may not be utilized.

The contextual engine 250 may prioritize the relevant workflow solutionsbased on contextual cues. The contextual cues may be any input from theimage interpreter device 115 entered by the image interpreter performingthe imaging procedure. The context cues may include any type of inputsuch as cursor movements (e.g., via a mouse), text inputs (e.g., via akeyboard), selections of images/areas, etc. The contextual engine 250may mediate between the intent of the image interpreter and the workflowsupport technology of the workflow solutions. Accordingly, thecontextual engine 250 may be leveraged by feeding the output of theconfiguration engine 240 to prioritize the relevant workflow solutionsbased on contextual cues that are gathered. For example, if the intentof the image interpreter is identified and/or the normalized needs ofthe referring physician are provided as (1) creating a measurement wherethe measured object is oncological (e.g., through lesioncharacterization) and (2) including an oncological quantification, thecontextual engine 250 may launch the associated workflow solution.

The output engine 255 generates the information to be included in thereading environment based on information from the other engines 235-250.Specifically, the information may be the workflow solutions determinedby the other engines 235-250, a representation of the workflowsolutions, keywords of the needs of the referring physician, etc. Theoutput engine 255 may transmit an output to the image interpreter device115 prior to the image procedure being performed. Thus, when the imageinterpreter begins the imaging procedure, the image interpreter device115 may launch the output that shows the reading environment upon whichthe imaging procedure is to be performed. For example, when one or moreworkflow solutions were mapped by the configuration engine 240, theoutput may include these relevant workflow solutions which are shown tothe image interpreter for the imaging procedure to proceed accordingly.In another example, when no workflow solution is mapped, the output mayinclude normalized needs which are shown to the image interpreter suchthat the imaging procedure may be performed with these normalized needsas a consideration.

The reading environment may include a dedicated area in which therelevant workflow solutions are docked (e.g., positioned in the readingenvironment). That is, the exemplary embodiments may select a locationfor the dedicated area and provide the information in the dedicated areaof the reading environment. Another area of the reading environment maybe to show the images captured by the imaging procedure. If there are noworkflow solutions considered relevant, the area may be collapsed. Ifthe serialization engine 245 is being utilized, the workflow solutionsthat do not require an input from another workflow solution may bedocked until such input becomes available (in which the followingworkflow solution may be docked). The docking area may be updateddynamically. For example, if one workflow solution has been used thatprovides input to another, the following workflow solution may belaunched after the prior workflow solution is closed. When thecontextual engine 250 is being utilized, a prioritization of workflowsolutions may be provided. For example, based on how the contextualengine 250 cooperates with the output engine 255, only one, at most two,at most three, at most four, etc. workflow solutions may be shown at thesame time. In another example, only workflow solutions whose estimatedrelevance exceeds a predetermined threshold may be shown. In a furtherexample, based on the contextual cues being received from the imageinterpreter device 115, workflow solutions that are associated with thecontextual cues may be updated dynamically in view of these contextualcues.

Using the above mechanism of the workflow server 120, the exemplaryembodiments provide the proper identification of how an imagingprocedure is to be performed by an image interpreter to generate theappropriate test results for the referring physician. When the referringphysician places a request for the imaging procedure, the need detectionengine 235 may determine the normalized needs of the request for thereferring physician. The configuration engine 240 may then map thenormalized needs to workflow solutions that are to be used in thereading environment by the image interpreter. The serialization engine245 may be utilized to order the workflow solutions, if applicable. Theoutput engine 255 receives the outputs from these engines and generatesthe information to be included in the reading environment to be viewedby the image interpreter. The contextual engine 250 may be utilized todynamically update the workflow solutions of the reading environment, ifapplicable. In this manner, the image interpreter may perform orinterpret the imaging procedure using the workflow solutions that areshown in the reading environment. Since the workflow solutions areselected based on the needs of the referring physician, the test resultsof the imaging procedure that are generated and returned to thereferring physician are expected to meet any requirements of thereferring physician.

It is noted that the test results of the imaging procedure may beprovided to the referring physician in a variety of ways. For example,the test results may be mailed (e.g., electronically) to the referringphysician. In another example, the image interpreter device 115 may beconfigured to transmit the test results to a network storage componentor network service. Thereafter, the referring physician (or any otherauthorized user) may access and/or retrieve the test results. In afurther example, the workflow serer 120 may include a further component(e.g., a transfer engine) that performs the functionality of forwardingthe test results from the image interpreter device 115 to the physiciandevice 105.

FIG. 3 shows a method 300 for determining a reading environmentaccording to the exemplary embodiments.

Specifically, the method 300 may relate to the mechanism of theexemplary embodiments in which the reading environment used by an imageinterpreter in performing an imaging procedure is prepared based onneeds of a referring physician. Accordingly, the method 300 will bedescribed from the perspective of the workflow server 120. The method300 will also be described with regard to the system 100 of FIG. 1 andthe plurality of engines 235-255 of the workflow server 120 of FIG. 2.

For illustrative purposes, it may be assumed that the physician device105, the image interpreter device 115, the workflow server 120, and thesolution repository 125 are all communicatively connected to one another(e.g., via the communications network 110). It may also be assumed thatthe physician device 105 and the image interpreter device 115 each havean application launched thereon that operates in cooperation with theworkflow server 120.

In step 305, the workflow server 120 receives an input from thephysician device 105. Specifically, the workflow server 120 may receivea request from the physician device 105. As described above, thereferring physician may enter a request and/or other information ontothe physician device 105. The request and the other information may beforwarded to the workflow server 120 prior to the request beingserviced. The request may be provided by the referring physician using avariety of different mechanisms. In a first example, the request may beentered with free text. In a second example, the request may be enteredusing a dedicated user interface environment.

In step 310, the workflow server 120 determines the needs of thereferring physician. As described above, the needs of the referringphysician may be determined based on the request and/or the otherinformation provided from the physician device 105. Based on the mannerin which the request and the other information is received, the workflowserver 120 may identify normalized needs from a predetermined datascheme. For example, when the request is entered with free text, theworkflow server 120 may utilize natural language processing to determinekeywords or phrases to identify the normalized needs. In anotherexample, when the request is entered with the dedicated user interfaceenvironment, a direct correlation between the selections on thededicated user interface environment and the normalized needs may bedetermined. In a further example, the other information such asidentifying information of the physician device 105 or the referringphysician may be used to identify a user profile. In yet anotherexample, the request and/or the identity of the referring physician maybe used to identify a dedicated profile having a predetermined set ofnormalized needs.

Also in step 310, the workflow server 120 may map the normalized needsof the referring physician. Specifically, the workflow server 120 maymap the normalized needs to any relevant workflow solutions. Asdescribed above, the workflow solutions may be stored in the solutionrepository. In a particular example, the workflow solutions may eachhave an associated set of keywords or phrases that identify a relevance.When at least a minimum number of these associated keywords/phrases areincluded in the normalized needs, the workflow server 120 may determinewhether the workflow solution is to be selected for mapping. Theworkflow server 120 may also track a relevance value which is determinedbased on a correlation of the associated keywords/phrases to thenormalized needs. Thus, when the relevance value is above apredetermined threshold, the workflow server 120 may map the workflowsolution and include the workflow solution as part of the readingenvironment. It is again noted that it may be possible that only one orno workflow solution is identified.

In step 315, the workflow server 120 determines a workflow solutionserialization. As described above, when more than one workflow solutionis identified, the workflow server 120 may utilize a feature in which aserialization or ordering of the workflow solutions may be identified.Initially, it is again noted that even when more than one workflowsolution is identified, there may be no serialization. For example, allworkflow solutions may be independent and not rely on any output ofanother workflow solution. However, if a serial dependency is identifiedbetween two or more workflow solutions, the workflow server 120 maytrack this serialization that is applied to the reading environment.

The method 300 may be modified to address when no serial dependencyexists or when only one or no workflow solutions are identified. Forexample, prior to step 315, the method 300 may include a step thatdetermines whether there is less than two workflow solutions identified.If less than two workflow solutions are identified, the method 300 mayomit step 315 and continue to step 320. However, when more than oneworkflow solution is identified, the method 300 may consider step 315.In another example, when more than one workflow solution is identified,the method 300 may include a step that determines whether there is anyserial dependency among the workflow solutions. In a particularembodiment, each workflow solution may have any serial dependency thatis predetermined and associated therewith. Thus, identification of anyworkflow solution having an associated dependency may identify a serialdependency.

In step 320, the workflow server 120 generates the information to beincluded in the reading environment and transmits the modification forthe reading environment to the image interpreter device 115. The imageinterpreter device 115 may be configured to incorporate the informationinto the reading environment that is being viewed by the imageinterpreter. Alternatively, the workflow server 120 may generate andtransmit a modified reading environment (including the information) tothe image interpreter device 115. Based on the workflow solutions thatare identified from the normalized needs of the referring physician, thereading environment in which the image interpreter is to use to performthe imaging procedure may be provided. For example, a predetermined areaof the reading environment may show any workflow solution.

In step 325, the workflow server 120 receives inputs from the imageinterpreter device 115. As described above, the workflow server 120 mayinclude another enhanced feature in which contextual cues from the imageinterpreter are used to dynamically update or modify the readingenvironment and/or the workflow solutions. Thus, during the course ofperforming the imaging procedure as well as utilizing the readingenvironment as provided previously, any contextual cues may be received.When received, in step 330, the workflow server 120 updates/transmitsthe reading environment to the image interpreter device 115.

When the imaging procedure has completed, in step 335, the workflowserver 120 receives the test results from the image interpreter device115. As described above, one implementation of the exemplary embodimentsrelates to the workflow server 120 including a functionality offorwarding the test results from the image interpreter device 115 to thephysician device 105. Accordingly, when the workflow server 120 receivesthe test results, in step 340, the workflow server 120 transmits thetest results to the physician device 105. Since the imaging procedurewas performed with consideration of the needs of the referringphysician, the test results also incorporate the needs of the referringphysician.

The exemplary embodiments provide a device, system, and method ofgenerating test results of an imaging procedure that match the needs ofa referring physician. Specifically, when a request for an imagingprocedure is made for a patient by the referring physician, a workflowserver determines the needs of the referring physician. Based on theseneeds, the workflow server may identify workflow solutions or manner inwhich an image interpreter is to perform the imaging procedure.Accordingly, using a needs based defined imaging procedure, test resultstherefrom meet any requirements of the referring physician.

Those skilled in the art will understand that the above-describedexemplary embodiments may be implemented in any suitable software orhardware configuration or combination thereof. An exemplary hardwareplatform for implementing the exemplary embodiments may include, forexample, an Intel x86 based platform with compatible operating system, aWindows platform, a Mac platform and MAC OS, a mobile device having anoperating system such as iOS, Android, etc. In a further example, theexemplary embodiments of the above described method may be embodied as acomputer program product containing lines of code stored on a computerreadable storage medium that may be executed on a processor ormicroprocessor. Computer readable storage medium is included inhardware. Computer program product containing lines of code includes forexample software or firmware. The storage medium may be, for example, alocal or remote data repository compatible or formatted for use with theabove noted operating systems using any storage operation.

It will be apparent to those skilled in the art that variousmodifications may be made in the present disclosure, without departingfrom the spirit or the scope of the disclosure. Thus, it is intendedthat the present disclosure cover modifications and variations of thisdisclosure provided they come within the scope of the appended claimsand their equivalent.

What is claimed is:
 1. A method, comprising: at a workflow server:receiving a request from a physician device utilized by a referringphysician, the request directed to performing an imaging procedure;determining at least one normalized need from the request filtered froma set of normalized needs associated with a predetermined data schemelisting the needs of the referring physician in a hierarchical structurebased on the specialty of the referring physician, the normalized needcorresponding to the referring physician; generating a readingenvironment including a first area, a second area separate from thefirst area and information based on the at least one normalized need,the information assisting an image interpreter in interpreting theimaging procedure, wherein the first area in the reading environment isdedicated to the information and the second area in the readingenvironment is dedicated to showing images captured during the imagingprocedure, wherein the information and the images do not overlap;mapping the at least one normalized need to workflow solutions, eachworkflow solution associated with a set of relevant keywords, whereinthe mapping occurs when the set of relevant keywords of the at least oneworkflow solution is included in the one normalized need and a relevancevalue for the set of keywords is above a predetermined threshold;generating an updated reading environment based on the at least oneworkflow solution wherein the at least one workflow solution is includedin the first area of the reading environment; generating a modifiedreading environment that incorporates the information into the readingenvironment transmitting the modified reading environment to an imageinterpreter device utilized by the image interpreter; receiving at leastone contextual cue from the image interpreter device, wherein the atleast one contextual cue comprises a specific mouse cursor gesturecorresponding to a specific workflow solution; and updating the readingenvironment based on the at least one contextual cue.
 2. The method ofclaim 1, further comprising: when the request is received in a free textformat, performing a natural language processing operation to determineat least one keyword; and determining the at least one normalized needfrom the at least one keyword.
 3. The method of claim 1, furthercomprising: when the request is received with at least one selection ina dedicated user interface, determining the at least one normalized needfrom the at least one selection.
 4. The method of claim 1, furthercomprising: when the request is received with an identification,determining a profile, the profile including the at least one normalizedneed, wherein the profile is a dedicated profile, the identificationbeing a dedicated header that identifies the dedicated profile, andwherein the profile is a user profile, the identification being anidentity of the referring physician.
 5. The method of claim 1, furthercomprising: when the at least one workflow solutions has a serialdependency, determining the serial dependency; and updating the readingenvironment based on the serial dependency.
 6. The method of claim 1,further comprising: receiving test results from the imaging procedure;and transmitting the test results to the physician device.
 7. A workflowserver, comprising: a transceiver communicating via a communicationsnetwork, the transceiver configured to exchange data with a physiciandevice utilized by a referring physician and an image interpreter deviceutilized by an image interpreter; a memory storing an executableprogram; and a processor that executes the executable program thatcauses the processor to perform operations, comprising: receiving arequest from a physician device utilized by a referring physician, therequest directed to performing an imaging procedure; determining atleast one normalized need from the request filtered from a set ofnormalized needs associated with a predetermined data scheme listing theneeds of the referring physician in a hierarchical structure based onthe specialty of the referring physician, the normalized needcorresponding to the referring physician; generating a readingenvironment including a first area, a second area separate from thefirst area and information based on the at least one normalized need,the information assisting an image interpreter in interpreting theimaging procedure, wherein the first area in the reading environment isdedicated to the information and the second area in the readingenvironment is dedicated to showing images captured during the imagingprocedure, wherein the information and the images do not overlap;mapping the at least one normalized need to workflow solutions, eachworkflow solutions associated with a set of relevant keywords, whereinthe mapping occurs when the set of relevant keywords of the at least oneworkflow solution is included in the one normalized need and a relevancevalue for the set of keywords is above a predetermined threshold;generating an updated reading environment based on the at least oneworkflow solution wherein the at least one workflow solution is includedin the first area of the reading environment generating a modifiedreading environment that incorporates the information into the readingenvironment transmitting the modified reading environment to an imageinterpreter device utilized by the image interpreter; receiving at leastone contextual cue from the image interpreter device, wherein the atleast one contextual cue comprises a specific mouse cursor gesturecorresponding to a specific workflow solution; and updating the readingenvironment based on the at least one contextual cue.
 8. The workflowserver of claim 7, wherein the request is received in a free textformat, and wherein the processor performs operations further comprisingperforming a natural language processing operation to determine at leastone keyword and determining the at least one normalized need from the atleast one keyword.
 9. The workflow server of claim 7, wherein therequest is received with at least one selection in a dedicated userinterface, and wherein the processor performs operations furthercomprising determining the at least one normalized need from the atleast one selection.
 10. The workflow server of claim 7, wherein therequest is received with an identification, wherein the processorperforms operations further comprising determining a profile, theprofile including the at least one normalized need, wherein the profileis a dedicated profile, the identification being a dedicated header thatidentifies the dedicated profile, and wherein the profile is a userprofile, the identification being an identity of the referringphysician.
 11. The workflow server of claim 7, wherein the at least oneworkflow solutions has a serial dependency, wherein the processorperforms operations further comprising determining the serial dependencyand updating the reading environment based on the serial dependency. 12.A method, comprising: at a workflow server: receiving a request from aphysician device utilized by a referring physician, the request directedto performing an imaging procedure; determining at least one normalizedneed from the request filtered from a set of normalized needs associatedwith a predetermined data scheme listing the needs of the referringphysician in a hierarchical structure based on the specialty of thereferring physician, the normalized need corresponding to the referringphysician; determining at least one workflow solution based on the atleast one normalized need, the at least one workflow solutionrespectively associated with defining a manner that the imagingprocedure is to be performed; generating a reading environment based onthe at least one normalized need, the reading environment providing theat least one workflow solution, wherein a first area in the readingenvironment is dedicated to information based on the at least onenormalized need and a second area in the reading environment isdedicated to showing images captured during the imaging procedure,wherein the information and the images do not overlap; mapping the atleast one normalized need to workflow solutions, each workflow solutionsassociated with a set of relevant keywords, wherein the mapping occurswhen the set of relevant keywords of the at least one workflow solutionis included in the one normalized need and a relevance value for the setof keywords is above a predetermined threshold; generating an updatedreading environment based on the at least one workflow solution whereinthe at least one workflow solution is included in the first area of thereading environment generating a modified reading environment thatincorporates the information into the reading environment transmittingthe modified reading environment to an image interpreter device utilizedby the image interpreter; receiving at least one contextual cue from theimage interpreter device, wherein the at least one contextual cuecomprises a specific mouse cursor gesture corresponding to a specificworkflow solution; and updating the reading environment based on the atleast one contextual cue.